By Moazzum Bajwa, MD
Every month, I take our resident physicians to local high schools as part of a pipeline program in health education and advocacy. We teach the students how to advocate effectively for healthy change in their communities. These teenagers find their voice in brilliant and imaginative ways, sharing their stories through videos, displays, PhotoVoice and skits. Our resident physicians both guide and experience the transformative power of art in action, while serving a dual role as change-makers and role models in their local community.
This power of art is similarly reflected in the work of the family physician. While often overlooked when held against clinical studies, artistic expression fulfills many purposes in our profession: it promotes our own well-being through mindfulness; it helps strengthen our valuable connections, and it encourages us to share stories creatively as leaders and advocates. In this issue of California Family Physician, we are proud to highlight our members who embody these ideas through their dedication to the arts.
The mindful physician is self-aware and open to the exploration of new concepts of practice. Whether in the classroom or the clinic, mindfulness in medicine requires the same reflection and dedicated practice involved in artistic expression. This forces us to pay attention to finer details of the world around us. A musician explores their talent within applied theory to find their own “sound,” just as a physician searches for their own “style” in clinical practice. Similarly, we can apply descriptive imagery of visual art in examining a classic Rembrandt or a chest radiograph. The perceived mental and physical health benefits of art and music therapy are well stated, both in the production and consumption of creative works. A 2012 study in the Journal of Epidemiology and Community Health demonstrated that participating in “receptive and creative cultural activities” was associated with better satisfaction with health and lower rates of anxiety and depression; this held true across socio-economic cofactors.
The physician who uses art to explore their own thoughts and feelings can also better form therapeutic bonds with their patients. Narrative art, or storytelling through prose or poetry, asks us to imagine a character’s point-of-view, which is exactly what we expect of our learners during a patient visit as they navigate a history and physical. We hope that a thoughtful perspective will remove the lenses of implicit and explicit bias. Indeed, several medical schools promote humanities curricula designed on active listening and focused communication – all with the goal of improving the physician-patient relationship. Through this creative work, we become cognizant of how our descriptions and language shape the experience of our patients. And that same perspective allows us to see our patients in a much broader context; we find common threads of humanism between our shared stories from Eureka to San Diego.
Narrative art further allows writers to explore their frustrations with the fractured systems of health access and delivery. The art itself is not a substitute for the systems-level advocacy needed to make effective change, but it allows us to contextualize the challenges we face. The ability to “think outside the box” is how we create the paradigms that ultimately bring reasoned solutions for these community challenges. “The Nocturnists,” a medical storytelling platform, is one example of exactly that kind of narrative art; the San Francisco-based initiative allows physicians to share their experiences creatively in medicine with a live audience.
It is these stores—those of our patients, of our own struggles and successes, of our precious interactions at the most human level—that drive us and give meaning and depth to our work. We are privileged to witness first-hand these beautiful and powerful narratives. It should be easy, then to find creative ways to magnify our work on a larger scale: spoken word poetry, graphic novels and comics, or even an op-ed piece. But the innate desire to share our stories through art is often stifled by some combination of professional humility and subconscious desensitization; we assume that the gauntlet of shared experiences in medical training makes our profound one-on-one interactions mere commonplace. As a result, we rarely share this beauty with the rest of the world around us. This mindset deprives us of the tremendous joy in appreciating each story as a unique part of our transformation as healers, and further distances our community from realizing its shared humanity.
Our challenge, then, is to embrace our creativity as integral to our role as physicians and actively pursue opportunities to share our work. The hope is that by exploring storytelling through art, our reach as physicians will extend beyond one-on-one interactions into the population level as public health education and advocacy.
Beyond the stories of our patients, art allows us to share and celebrate the diversity of our specialty in family medicine. Artistic expression can describe who we are, our values and our work as the backbone of the healthcare world. We can explore and showcase the breadth and depth of our field through any number of creative outlets. Think of the sincere appreciation we receive when we share our daily stories with folks working outside of medicine: we should harness that energy into sharing our brilliant work as family physicians.
That starts with finding and sharing our own voice through art. Most of us consider these artistic pursuits to be “hobbies,” but I encourage you to frame your art as more than a diversion from work. One of our most influential figures in modern medicine, William Osler, recognized the practice of medicine as both art and science and placed great emphasis on the humanities. Our challenge is to recognize that science and art are not separate entities, but rather intensely connected to each other and worthy of equal weight in our collective journey. For every medical conference we attend or clinical podcast we download, let us commit similar time to a community art walk or orchestra. The CAFP has led by example in recent years by promoting narrative art of our physicians at the Family Medicine Summit, holding a StorySLAM event in 2017 and inviting The Nocturnists as keynote speakers in 2018.
Ultimately, we are responsible for cultivating the narrative of our profession for ourselves, our patients and our communities; this is especially critical in the current age of mis-information. While generally feeling unworthy of that responsibility, I can draw inspiration from the physicians on the following pages who embrace their artistic pursuits and recognize the value they bring to their work. I sincerely hope you will find that same encouragement in picking up your own instrument: whether a pen, a camera, a brush, a guitar, a microphone or the like. Thank you for sharing your stories with us and being a part of this community.
1. Emerging Health Advocates – H.E.L.P in the Community – RUHS/UCR Family Medicine Residency Program: www.emergingadvocates.com
2. “Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway.” Cuypers, et al. J Epidemiol Community Health. 2012 Aug; 66(8): 698–703. Published online 2011 May 23. doi: 10.1136/jech.2010.113571 - https://www.ncbi.nlm.nih.gov/pubmed/21609946/